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WAS �PERMIT <br /> SAN.I0A0I1JN CO UNIVENVISAONI%IENTA I,I I I A 1:TII D FPA� N1 I X1 .1041 E WEIIER AVI, STOUkTON CA 95202 - (209)468-3420 <br /> NON-REFUNDAULL PE'RMIT 'AIA,(209) '15,1-7697 vmt I.N -FIONS <br /> EXPIRES I YEAR FROM DATE ISSUED <br /> J oil A I)i)Rvss <br /> CR O's"S"'R r APN & <br /> PARCEL SIZE <br /> tv <br /> (-)wNFR NAMJ: PRONE x <br /> fir, A i wve_7' <br /> OWNER Aww_ss >21( A /f-� CI 111% MOP&�SIO C4 CIS <br /> X <br /> CONTRACTOR Ce <br /> PHONE i:�eg 401 <br /> CITY/STATE/ZIP IR p K E7 <br /> LICENSE C3 C42 C3 C-36 OTII17R NUMBER EXPIRATION DATE <br /> WATER TABLE DEPTH: 11 GEOCRAPIHCAL INFORMATION: Coordinates X Y <br /> I <br /> Q PERC TEST A '3 �ILDINCPFIRMIT# LAND USE APPLICATION# <br /> TYPE OF WORK: <br /> 0 NEW INSTALLATION Q REPAIRIADDITION LJ ' ENGINEER DF91GNED/ALTERNATIVE <br /> C3 REPLACEMENT 0 DESTRUCTION <br /> INSTALLATION WILL SERVE; Ll RESIDENCE 0 COMMERCIAL 0 OTHER <br /> NUMBER or LIVING UNITS: NuMimiz OF BFDROONtS: NUMBER OF EMPLOYEES: <br /> SEPTIC TANK TYPL/MFG CAPACITY gal A OF COMPARTMENTS <br /> 0 CREASE TRAP CAPACITY gal A OF COMPARTMENTS J <br /> 0 PkG TX PLANT W111 11 I:OIJNI)Al'l()NMomR'i,y LINT: II <br /> LIFTSTATION 01:111INII, 0 <br /> SANI)OII,,Sl-'PAIIATOR(EN(,i,osi,.oSYSI'EM) <br /> ❑ LEACH LINES El LEACHING CHAMBERS A OF LINES LENGTH OF LINES ft <br /> DISTANCE To NEAREST WELL ft FOUNDATION-- ft PROPERTY LINE A <br /> ❑ FILTER BED WIDTH It LENGFI-I fl DEPTH A <br /> DBTANCE'ro NF.ARr.,%'r WELL — III FOUNDATION It PROPERTY LINE n <br /> L3 MOUNDED WIDTII 11 LFNGTI I ft DEPTH fl <br /> DISTANCE To NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft <br /> El sumps Wu)TH fl LENGTH LENGTH DEPTH fl <br /> DISTANCE TO NFARFST WELL_ ft FOUNDATION ft PROPERTY LINE <br /> LI DISPOSAL PONDS WFDTII fl LENGTH _f1 DEPTH It <br /> DISTANCE To NEAREST WELL ft FOUNDATION fl PROPERTY LINE fl <br /> El SEEPAGE PITS NumiwR —WIDTH ft DEPTH fl <br /> DISTANCE To NEAREST WELL 1t POUNDAI ION ft PROPERTY LINE <br /> IIIERFBYC' 'IFYTHATE I HAVE;PREPARED THIS APPLICATION AND THF:WORK WILL IIF DONE IN ACCORDANCE WITH SAN JOAQUIN COUNTY <br /> ^I OR iNANCE:S,C <br /> S'PAT'E LAWN AND RULES AND RF,(;UI,ATIONS OF SAN JOAQUIN COUNTY, <br /> F. <br /> 'ANCNO FICV RFQI 11RI-J) ,)R INSPEUTIONS—PLEASE CALL(209)953-7697 <br /> SIGNED TITLE DATF ol <br /> L <br /> A <br /> ILA R_2- <br /> 2, rq <br /> AC C, <br /> a At <br /> 14 <br /> Z LIF I <br /> HE <br /> 6��-rmrS ONIV <br /> AR MIEN1 I SIE I <br /> Applicalion Accepted B.v <br /> Area Employee IDA <br /> Filial Inspection By DA(C SPECIAL PERMIT-Approved by <br /> Character of Soil to Accepted <br /> �of]l Ft: Pit/Sump Soil Character: <br /> COM�11-�NTS 'ne z <br /> _ ' 7 <br /> PE sc IV,!c i A Amount Dale Permilt I nvoice A Permit IDN <br /> Code 1141:0 ly q I Remillell Service Itcouest A <br /> 'tq 3 <br /> z <br /> 42-02001 ONSI IT WASTI-IWATER PERMI I' <br /> 1212212()03 <br />